Rep. Mike Rogers, R-Mich., told the House Energy & Commerce Health Subcommittee last week that health insurance agents and brokers are in a "desperate situation," due to medical loss ratio (MLR) determinations.
The existing regulations that are part of President Obama’s Patient Protection and Affordable Care Act, consider agent and broker fees nonmedical expenses. Health insurers in the individual and small group market, under the reform act, must devote 80% of their premiums to covering medical costs. In the large group market, that requirement is 85%. If these standards are not met, insurance carriers are also required under the reforms to provide rebates to policyholders (starting in 2012) for premiums paid in the previous year.
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